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Metabolic Syndrome and Lupus

Reviewed by: HU Medical Review Board | Last reviewed: January 2020

Metabolic syndrome is the name for a cluster of symptoms that place you at greater risk for cardiovascular problems, type 2 diabetes and stroke. Some people refer to it as pre-diabetes because so many people with the condition go on to develop diabetes.

Research indicates that about 35 percent to 45 percent of people with lupus also had metabolic syndrome, compared to 23 percent in the general U.S. population.1-3

What are the symptoms of metabolic syndrome?

According to the American Heart Association, a person is said to have metabolic syndrome when they have 3 or more of the following risk factors:2

  • Abdominal obesity (Waist circumference of more than 40 inches in men, and more than 35 inches in women)
  • Triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or higher
  • HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Systolic blood pressure (top number) of 130 millimeters of mercury (mm Hg) or greater, or diastolic blood pressure (bottom number) of 85 mm Hg or greater
  • Fasting glucose of 100 mg/dL or greater

What causes metabolic syndrome?

Metabolic syndrome is most common in anyone who is overweight or obese, physically inactive, and older. In people with lupus, metabolic syndrome can be a case of “What came first, the chicken or the egg?”

The joint pain, fatigue, arthritis, photosensitivity, and depression of lupus may make physical activity difficult, which can make it harder to control your weight. Lupus may also attack the heart and blood vessels, creating a higher risk for cardiovascular issues. Attacks on the kidneys increase the risk of higher blood pressure. Plus, long-term steroid use, one of the most common ways to control lupus, can trigger insulin resistance (high blood sugar levels) and high blood pressure.4

More dangers of lupus and metabolic syndrome

Having lupus provides additional risk factors for developing metabolic syndrome, especially if lupus has damaged your major organs, you are older or have had lupus for a longer period of time.1

One study found that people with lupus who have major organ involvement also tended to show higher blood cholesterol and higher blood sugar fasting values. These findings may explain why people with lupus and metabolic syndrome are more likely to develop diabetes.1

Another study found that people with lupus and metabolic syndrome had more severe disease, more frequent flares, longer and larger amounts of steroid use, less use of antimalarials, more organ damage, and lower quality of life.3

How is metabolic syndrome treated?

The good news is that the risks of metabolic syndrome can be improved with changes to diet and exercise. The first recommendation to treat metabolic syndrome involves healthier eating and getting more exercise in order to lose weight, and lower blood sugar, cholesterol, and blood pressure numbers. Specific to people with lupus, this may require working with your doctor to address symptoms of pain, fatigue, and depression that may discourage you from getting enough exercise. You should aim for 30 minutes or more of exercise most, if not every, day.

One study from the University of Kansas School of Medicine found that lifestyle changes decreased the rate of metabolic syndrome progressing to type 2 diabetes by 58 percent.5

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